Evidence and Clinical Guidelines
Where possible we pursue an evidence-based approach. There is increasing evidence for some of our interventions and decreasing evidence for other. The following is a sample of some recent guidelines or reviews.
In a systematic review of non-invasive physical treatments for chronic/recurrent headache (Cochrane 2004) it was found that spinal manual therapy may be an effective treatment option with a short term effect similar to that of a commonly used effective drug (amitriptyline)
In a systematic review conducted in the Netherlands in 2000 it was found that there was virtually no conclusively clinically relevant effects of ultrasound, laser and electric current based therapies and concluded that their current use in clinical practice is not justified.
Low Back Pain
Clinical practice guidelines (2007) produced from the American Pain Society and the American College of Physicians concluded that in cases of low back pain where self care options do not work then the following non-pharmacological interventions are recommended:
- Acute Low Back Pain - Spinal Manipulation/manual therapy
- Chronic or Subacute Low Back Pain – intensive interdisciplinary rehabilitation, acupuncture, manual therapy, exercise
The Ottawa Panel evidence based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis stated that “the use of therapeutic exercises alone or in combination with manual therapy is recommended for managing patients with osteoarthritis.”
Rotator Cuff Impingement
A systematic review of the evidence for exercise in the treatment of rotator cuff impingement published in the Journal of Shoulder and Elbow Surgery in 2009 concluded that exercise has significant effects on pain reduction and on improving function. Manual therapy augments the effects of exercise. The Journal of Rehabiliation Medicine 2009 examined the effects of physiotherapy in patients with shoulder impingement syndrome and concluded that physiotherapy was as effective as surgery for the sample studied.
A study published in the journal Physical Therapy in Sport examined the use of foot orthoses in the treatment of plantar fasciitis and concluded that “the use foot orthoses in patients with plantar fasciitis appears to be associated with reduced pain and improved function.”
Lateral Ankle Sprains
In the American Journal of Sports Medicine in 1999 a systematic review of the literature concluded that “we recommend that athletes with a sprained ankle complete supervised rehabilitation before returning to practice or competition, and those suffering from a moderate or severe sprain should wear an appropriate orthosis (ankle guard) for 6 months.
Rehabilitation after surgery
Advanced Physio's therapists also have expert knowledge in rehabilitative exercise programs following various surgical procedures including
- Knee and Anterior Cruciate Ligament Reconstruction
- Patella Stabilisation surgery
- Foot and ankle surgery
- Achilles Tendon repair
- Spinal surgery
- Hip Labral Tear repair